Therapeutic angiogenesis is a procedure developed for the treatment of ischemia whereby new blood vessels are induced to grow in ischemic tissue in response to exogenous angiogenic growth factors delivered by genes or cells. The main clinical targets are myocardial and critical limb ischemia caused respectively by coronary and peripheral artery disease. Persuasive preclinical results of both gene and precursor stem cells lead to a series of Phase II/III clinical trials. These have been only moderately successful, revealing safety of the procedures but minimal efficacy.